Increasing Protein and Calories

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Client s Name: Registered Dietitian s Name: Phone # 705-522-6237 ext- Toll Free # 1-877-228-1822 ext Increasing Protein and Calories Date: Poor appetite and weight loss are very common side effects that can occur while going through your treatment. Nutrition plays a very important role in your tolerance to treatment and over all well-being. You may benefit from a high protein, high calorie diet during your treatment or recovery to maintain your strength and weight. Protein is essential in building and repairing muscles, organs, skin, hair and bones. It also helps the body in fighting infection. Helpful Hints to Increase Protein: Food Item Protein/Serving Where to Use Milk 8 grams/1 cup Add to cereal, coffee, smoothies, milkshakes, mashed potatoes Use in baked goods, desserts, casseroles, egg dishes, cream soups, sauces Add to Jello instead of cold water Fortified Soy Milk 7 grams/1 cup Use in place of dairy milk for Cheese (cheddar, mozzarella, brie, camembert, goat etc) intolerances/allergies 7.5-15 grams/1.5 oz Add slices of cheese to fruit or crackers Add to toast, breads muffins Grate into vegetables, soups and sauces Use in: o Sandwiches, burgers o Eggs (scrambled, omelets) o Casseroles o Potatoes, pasta, rice 1

Food Item Protein/Serving Where to Use Cottage, Ricotta Cheese 15 grams/ ½ cup Mix with fruits and vegetables Use in: o Pasta (manicotti, lasagna) o Cheese cake, puddings o Casseroles o Egg dishes (soufflés, quiche, scrambled eggs, omelets) Add to pancakes crepes and waffles Greek Yogurt 14-18grams/ ¾ cup Mix with fruits and desserts Add to pancake or waffle mixes Add to milk-based beverages & gelatin desserts Stir into vegetable, casseroles and pasta dishes Use as a snack or dessert Make a parfait with granola and fruit RegularYogurt 6 grams/ ¾ cup Can be used same as Greek Yogurt Skim Milk Powder 8 grams/ 1/3 cup High Protein Milk: o Dissolve 1 cup (250ml) of milk powder into 4 cups homogenized milk. Refrigerate. Add to: o Hot cereals, scrambled eggs, milkshakes, eggnog, pudding mixes, yogurt, mashed potatoes o Gravy and cream soups o Casseroles o Recipes for baked goods Peanut Butter 8 grams/ 2 Tbsp Spread on sandwiches, toast, muffins, crackers, waffles, pancakes, raw fruit and vegetable slices Use in peanut butter cookies, squares, muffins, cakes, icings Blend with milk drinks Swirl through soft ice-cream & yogurt Almond Butter 7 grams/ 2 Tbsp Can be used same as peanut butter 2

Food Item Protein/Serving Where to Use Nuts/seeds 4-7grams/ 1 oz Add chopped or ground to yogurt, ice cream, puddings, cereals, muffins, pancakes, waffles, breads, cookies, casseroles, hamburgers, meatloaves, vegetable dishes, pasta dishes, salads, sandwich fillings Snack on nuts between meals Wheat Germ 13 grams/ ½ cup Replace flour when baking Stir into oatmeal Add to cereal or yogurt Add to smoothies or milkshakes Use in place of bread crumbs Eggs 12 grams/ 2 eggs Add to salads, sandwiches, crackers Meat, Fish, Poultry 16-20 grams/ 2.5 oz Add to soups, sauces, casseroles, omelets, quiches, stuffing, salads Use as a sandwich filling Legumes (Beans and Peas) 10-12grams/ ¾ cup Add cooked legumes to soups, casseroles, pasta and grain dishes (rice, barley) Add to stir fries, chilli Use hummus as a dip or sandwich spread Tofu 20 grams/ 3 oz (150g) Can be used as a meat replacement in most recipes Choose extra firm tofu to add to stir fries, casseroles, chilli, soups, curry Choose silken tofu and add to smoothies, desserts, cream soups, sauces, egg dishes Soy Beans 20 grams/ ¾ cup Eat as a snack Add to stir fries, casseroles, salads, pasta dishes Quinoa 4 grams/ ½ cup Use as a replacement for rice or pasta Add to salads or casseroles Use as a side dish for any meal Nutritional Supplements Commercial nutritional supplements are rich in energy, proteins, vitamins and minerals. Your registered dietitian can assist you in determining the most suitable supplement for you. Nestle Carnation Breakfast Essentials powder, when added to homogenized milk, is a very good source of protein and calories. It is available at most grocery stores. It can also be added to hot cereal or pudding mixes. 3

Easy Ways to Increase Protein Intake Instead of Try Typical plain or fruit yogurt Greek yogurt =6g of protein =15 g of protein (175 ml or ~¾ cup) (175 ml or ~ ¾ cup) Sour cream Ricotta cheese ~1g protein =15g of protein (15mL or 1 tbsp) (125mL or ½ cup) White Rice Quinoa =4g of protein =8g of protein (1 cup, cooked) (1 cup, cooked) Jell-O Pudding Cup Instant Jell-O Pudding (Made with 2 cups = 1g of protein of fortified milk) (1 snack cup ½ cup) = 6g protein (½ cup) 4

Helpful Hints to Increase Calories: Eat every 2-3 hours, rather than waiting until you feel hungry Eat larger meals when you feel hungriest. For example, if you feel hungriest at breakfast, eat your largest meal then. Have prepared snacks available and on-hand (e.g., cheese and crackers, granola bars, yogurt) Drink juice, milk or milkshakes, as these offer more calories than plain water, tea or coffee Do not eat foods that are labelled Low Calorie, Calorie-Reduced, Light or Lite Make every mouthful count (e.g., add butter, peanut butter and jam to toast) Food Item Table Cream, Sour Cream, Whipped Cream Butter, Margarine, Oil Where to Use Use in soups, sauces, egg dishes, vegetable and fruit dips, sauces, batters, pudding or custards Put on cereals, gelatin desserts, fruit, pancakes, waffles Mix in with pasta, rice, potatoes, meat loaf Substitute for milk in recipes and hot beverages Add whipped cream to hot chocolate Add to potatoes, hot cereals, rice, noodles, cooked vegetables, eggs Use for pan frying foods Stir into sauces, gravy, soups, casseroles Combine with herbs and seasonings and spread on meats, hamburgers, fish Use melted on popcorn Use as a dip for vegetables or seafood (e.g. lobster, crab, etc Spread on toast, muffins, bread, pancakes, waffles, French toast or crackers 5

Food Item Ice Cream Avocado Cream Cheese Mayonnaise Dried Fruits (Raisins, figs, prunes, apples, dates, apricots) Granola Honey, Jam, Syrups, Brown Sugar Where to Use Add to smoothies or milkshakes Eat as a snack Top desserts or pastries Add to salads, on top of casseroles, soup or chilli Add to crackers, sandwiches, hamburgers, tacos use as a spread or dip for vegetables and breads Spread on sandwiches, bagels, muffins, crackers, fruit slices, vegetables Roll into balls and coat with chopped nuts, wheat germ, granola and use as a dip or spread Use in cheese cakes, vegetable and fruit dips, sauces Spread on sandwiches or crackers Use in place of salad dressing Use in potatoes, rice, and pasta salads Use in sauces or vegetable dips Use in devilled eggs Soak, cook and serve for breakfast or as desserts or as a spread on toast Add to muffins, cookies, cakes, bread, rice and grain dishes, cereals, puddings or stuffing Eat as a cereal Use in cookies, muffins or bread batter Sprinkle on fruit, yogurt, custards, ice cream, puddings Use when making fruit crisps (e.g. apple crisp) or date squares Use as a topping on cakes, breads Add to cereals, milk drinks, fruit desserts, yogurt, ice cream Use as a glaze for meats and poultry (e.g. ham, pork chops, chicken) Spread on toast, muffins, breads or crackers Pour over pancakes, waffles and French toast Use as a dip for fruit 6

High Calorie, High Protein Recipes Bread Pudding ½ cup sugar 125mL ½ tsp. cinnamon (omit if you have mouth sores) 2.5 ml ¼ tsp. salt 1 ml 2 eggs 2 4 cups high protein milk (recipe p. 2) 1 L 1 tsp. vanilla 5 ml 8 slices of bread cut in cubes 8 2 tbsp. melted butter 30 ml ½ cup of raisins (optional) 125 ml ½ cup pecans (optional) 125 ml Ice cream (optional)_ Mix sugar, cinnamon, and salt in a bowl. Beat in eggs. Add milk and vanilla. Stir in bread, raisins, peacans and butter. Pour into 9-inch (22.5 cm) square baking dish. Bake for 1 hour at 350 F (180 C). Top with a large scoop of ice cream. Makes 9 servings. 490 calories, 15 grams of protein per serving Power Milkshake 1 cup high protein milk 250 ml 1 generous scoop ice cream 1 scoop 1 tbsp honey 15mL 2 tbsp. chocolate syrup 30 ml 2 tbsp peanut butter 30 ml ½ Banana Measure all ingredients into a tall glass or blender. Stir or blend until well mixed. Makes one serving. 960 calories, 31 grams protein per serving. 7

Pasta and Cheese Sauce 1 cup small shell pasta 250 ml 2 tbsp butter 30 ml 2 tbsp all-purpose flour 30 ml 1 ½ cups milk, high protein milk or half and half cream 375 ml 1 cup shredded cheddar cheese 250 ml salt and pepper Cook pasta in boiling salted water until tender, about 7 to 8 minutes. Meanwhile, in small heavy saucepan melt butter over low heat. Whisk in flour and cook for 2 minute. Gradually whisk in milk and cook until mixture comes to a boil and thickens. Stir in cheese until melted. Drain pasta and stir into sauce. Season to taste with salt and pepper. Makes 2 servings Each serving provides 665 calories, 30 g protein (made with high protein milk) Berry Warm & Nutty Cinnamon Quinoa Recipe 1 cup high protein milk 250 ml 1 cup water 250 ml 1 cup quinoa (well rinsed) 250 ml 1 cup frozen, thawed berries 250 ml 1 tsp ground cinnamon 5 ml 1 tsp grated fresh ginger 5 ml 2 tbsp wheat germ 30 ml 1/3 cup chopped nuts (optional) 83 ml 1/3 cup dried fruit 83 ml 2 tbsp flax seed 30 ml 4 tbsp honey or maple syrup 30 ml Bring milk, water and quinoa to a boil over high heat, in medium saucepan. Reduce heat to medium-low, cover and simmer for 15 minutes (until most of the liquid is absorbed). Turn off heat, and let stand, covered, for 5 minutes. Stir in berries (with their juices), cinnamon, wheat germ and ginger. Top with nuts, dried fruit and drizzle with honey or syrup. Makes 4 servings Each serving provides: 470 calories, 17 g of protein Reference: Dietitians of Canada. (2002). High-Calorie, High-Protein Diet. Online: Dietetics at Work. 8